Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington.
Am J Trop Med Hyg. 2018 Apr;98(4):1197-1201. doi: 10.4269/ajtmh.17-0705. Epub 2018 Feb 8.
Two rotavirus vaccines, RotaTeq and Rotarix, are licensed for global use; however, the protection they confer to unvaccinated individuals through indirect effects remains unknown. We systematically reviewed the literature and quantified indirect rotavirus vaccine effectiveness (VE) for preventing rotavirus hospitalization in children aged less than 5 years. From 148 identified abstracts, 14 studies met our eligibility criteria. In our main analysis using a random-effects model, indirect rotavirus VE was 48% (95% confidence interval [CI]: 39-55%). In a subgroup analysis by country income level, indirect VE was greater in high-income countries (52%; 95% CI: 43-60%) than in low- and middle-income countries (LMICs) (25%; 95% CI: 5-41%). In a sensitivity analysis using a quality-effects model, the indirect VE in LMICs was not statistically significant (25%; 95% CI: 0-44%). Our findings highlight the importance of increasing rotavirus vaccine coverage, particularly in LMICs where evidence for indirect VE is limited and rotavirus burden is high.
两种轮状病毒疫苗，Rotarix 和 RotaTeq，已在全球获得许可；然而，它们通过间接效应对未接种疫苗的个体提供的保护仍然未知。我们系统地审查了文献，并量化了预防 5 岁以下儿童轮状病毒住院的间接轮状病毒疫苗有效性（VE）。从 148 篇已确定的摘要中，有 14 项研究符合我们的入选标准。在我们使用随机效应模型的主要分析中，间接轮状病毒 VE 为 48%（95%置信区间 [CI]：39-55%）。按国家收入水平进行的亚组分析显示，高收入国家（52%；95%CI：43-60%）的间接 VE 高于中低收入国家（LMICs）（25%；95%CI：5-41%）。在使用质量效应模型的敏感性分析中，LMICs 中的间接 VE 不具有统计学意义（25%；95%CI：0-44%）。我们的研究结果强调了增加轮状病毒疫苗覆盖率的重要性，特别是在间接 VE 证据有限且轮状病毒负担较高的 LMICs 中。
